Featured Peer-reviewed Publications

Methods and Issues Specific Studying Latino Health Equity in Primary Care

The PRIMER Center has pioneered work considering and using electronic health records to study ethnicity, nativity, immigration, and other policy issues in primary care, developing methods to impute oft-excluded information. These explorations have also included discussions of the ethics and safety of studying sensitive but important sub-group information in Latinos.

Heintzman, J, Marino, Clark, K. Cowburn S, Sosa S, Cancel L, Ezekiel-Herrera D, Cohen D. Using Electronic Health Record Data to Study Latino Immigrant Populations in Health Services Research. J Immigrant Minority Health (2019). https://doi.org/10.1007/s10903-019-00925-2

Heintzman J, Marino M. Race and Ethnicity Data in Research. JAMA. 2019 Mar 26;321(12):1217-1218. doi: 10.1001/jama.2018.21947.

Aviles-Santa ML, Heintzman J, Lindberg N, Guerrero-Preston R, Ramos K, Abraido-Lanza A, Bull J, Falcon A, McBurnie MA, Moy, E, Papanicolaou G, Pina IL, Popovic J, Suglia S, Vazquez M. Personalized medicine and Hispanic health: improving health outcomes and reducing health disparities. BMC Proceedings. 2017;11(Suppl 11):11.

Heintzman J, Bailey S, Devoe J, Cowburn S, Kapka K, Duong T-V, Marino M. In low-income Latino patients, post-ACA insurance disparities may be reduced even more than broader national estimates: evidence from Oregon. Journal of Racial and Ethnic Health Disparities. 2017;4(3):329-336.

Block R, Puro J, Cottrell E, Lunn M, Dunne MJ, Quinones A, Chung B, Pinnock W, Reid G, Heintzman J. Recommendations for improving national clinical datasets for health equity research. Journal of the American Medical Informatics Association. 2020 Nov 1;27(11):1802-1807. doi: 10.1093/jamia/ocaa144

Primary Care and Health Equity research in general

The PRIMER Center has led discussions stressing the importance of understanding, studying, and leveraging primary care and its policy environment in order to understand and advance health equity, as well as practical methods and approaches in this setting.

Heintzman J, Marino M. The Importance of Primary Care Research in Understanding Health Inequities in the United States. The Journal of the American Board of Family Medicine July 2021, 34 (4) 849-852; DOI: https://doi.org/10.3122/jabfm.2021.04.210060

Heintzman J, Marino M, Hoopes M, Bailey S, Gold R, O'Malley J, Angier H, Nelson C, Cottrell E, DeVoe J. Supporting health insurance expansion: do electronic health records have valid insurance verification and enrollment data? Journal of the American Medical Informatics Association. 2015;22(4):909-913.

Marino M, Lucas J, Latour E, Heintzman JD. Missing data in primary care research: importance, implications and approaches. Fam Pract. 2021 Mar 29;38(2):200-203. doi: 10.1093/fampra/cmaa134. PMID: 33480404; PMCID: PMC8243609.

Marino M, Bailey S, Gold R, Hoopes M, O’Malley J, Huguet N, Heintzman J, Gallia C, McConnell J, Devoe J. Oregon’s randomized insurance experiment: receipt of preventive services in community health centers. American Journal of Preventive Medicine. 2016;50(2):161-170.

Heintzman J, Gold R, Krist A, Crosson J, Likumahuwa S, Devoe J. Practice-Based Research Networks are promising laboratories for conducting dissemination and implementation research. Journal of the American Board of Family Medicine. 2014;27(6):759-762.

Bailey SR, Heintzman J, Marino M, Hoopes MJ, Hatch BA, Gold R, Cowburn SC, Nelson CA, Angier HE, DeVoe JE. Measuring preventive care delivery: comparing rates across three data sources. American Journal of Preventive Medicine. 2016 Nov;51(5):752-761.

Heintzman J, Marino M, Hoopes M, Bailey S, Gold R, Crawford C, Cowburn S, O’Malley J, Nelson J, Devoe J. Using electronic health record data to evaluate preventive service utilization among uninsured safety net patients. Preventive Medicine. 2014;67:306-310.

Heintzman J, Gold R, Bailey S, Devoe J. The Oregon experiment reexamined: the need for primary care in US health reform. British Medical Journal. 2014;349:g5976.

Marino M, Bailey SR, Gold R, Hoopes MJ, O'Malley JP, Huguet N, Heintzman J, Gallia C, McConnell KJ, DeVoe JE. Receipt of Preventive Services After Oregon's Randomized Medicaid Experiment. Am J Prev Med. 2016 Feb;50(2):161-70. doi: 10.1016/j.amepre.2015.07.032. Epub 2015 Oct 23. PMID: 26497264; PMCID: PMC4718854.

Bailey SR, Hwang J, Marino M, Quiñones AR, Lucas JA, Chan BL, Heintzman JD. Smoking‐Cessation Assistance Among Older Adults by Ethnicity/Language Preference. American journal of preventive medicine. 2022 September;63(3):423‐430. PubMed PMID: 35589442; PubMed Central PMCID: PMC10205054; DOI: 10.1016/j.amepre.2022.03.024.

Marino M, Fankhauser K, Minnier J, Lucas JA, Giebultowicz S, Kaufmann J, Hwang J, Bailey SR, Crookes DM, Bazemore A, Suglia SF, Heintzman J. Disaggregating Latino nativity in equity research using electronic health records. Health services research. 2023 October;58(5):1119-1130. PubMed PMID: 36978286; PubMed Central PMCID: PMC10480087; DOI: 10.1111/1475-6773.14154.

Heintzman J, Dang D, Lucas J, Byhoff E, Crookes D, April-Sanders A, Kaufmann J, Boston D, Hsu A, Gielbultowicz S, Marino M. Answering calls for rigorous health equity research: Leveraging electronic health records for data disaggregation in Latinos. Submitted to the Fam Med Community Health. Accepted April 2023.

Byhoff E, Dinh DH, Lucas JA, Marino M, Heintzman J. Mental Health Care Use by Ethnicity and Preferred Language in a National Cohort of Community Health Center Patients. Psychiatric Services. 2023:appi.ps.20220585. doi:10.1176/appi.ps.20220585

Marino M, Abraído-Lanza AF, Aceves B, Bello E, Echeverría SE, Flórez K, Galvez E, Jaén CR, López-Cevallos D, Lucas JA, Mojica CM, Rodriguez CJ, Rodriguez M, Vasquez-Guzman CE, Heintzman J. (2024) Building a Primary Care Research Agenda for Latino Populations in the Setting of the Latino Paradox: A Report from the 2023 Latino Primary Care Summit. Accepted: Journal of the American Board of Family Medicine.

Heintzman J., Marino M. Primary Care, Health Services, and the Latino Mortality Paradox. Accepted Sept 2024. Journal of Immigrant and Minority Health.

Latinos and Asthma/COPD Equity in Primary Care

The PRIMER Center has published a considerable amount of work demonstrating that Spanish preferring Latinos often access equitable asthma care at community health centers. This doesn’t extend to all measures however, and some evidence exists from their work that asthma may be less well controlled in this group.

Heintzman J, Kaufman J, Ezekiel-Herrera D. Bailey SR, Cornell A, Ukhanova M, Marino M. Asthma/COPD Disparities in Diagnosis and Basic Care Utilization Among Low-Income Primary Care Patients. J Immigrant Minority Health (2019) 21: 659. https://doi.org/10.1007/s10903-018-0798-2

John Heintzman, David Ezekiel-Herrera, Steffani R. Bailey, Arvin Garg,Jennifer Lucas, Shakira Suglia, Stuart Cowburn, Jon Puro & Miguel Marino (2020): Latino-white disparities in ICD-coded asthma diagnosis among US children, Journal of Asthma, DOI:10.1080/02770903.2020.1861628

Heintzman J, Kaufman J, Lucas J, Suglia S, Garg A, Puro J, Giebultowicz S, Ezekiel-Herrera D, Bazemore A, Marino M. Asthma Care Quality, Language, and Ethnicity in a Multi-State Network of Low-Income Children. Journal of the American Board of Family Medicine. September 2020, 33 (5) 707-715; DOI: https://doi.org/10.3122/jabfm.2020.05.190468

Lucas J, Marino M, Fankhauser K, Bailey SR, Ezekiel-Herrera D, Kaufmann J, Cowburn S, Suglia S, Bazemore A, Puro J, Heintzman J. Oral corticosteroid use, obesity, and ethnicity in children with asthma. Journal of Asthma. (2019) DOI: 10.1080/02770903.2019.1656228

Lucas JA, Marino M, Fankhauser K, Bazemore A, Giebultowicz S, Cowburn S, Kaufmann J, Ezekiel-Herrera D, Heintzman J. Role of social deprivation on asthma care quality among a cohort of children in US community health centres. BMJ Open 2021;11:e045131. doi:10.1136/bmjopen-2020-045131

Lucas JA, Marino M, Giebultowicz S, Fankhauser K, Suglia SF, Bailey SR, Bazemore A, Heintzman J. Mobility and social deprivation on primary care utilization among pediatric patients with asthma. Family Medicine and Community Health. 2021;9:e001085. doi:10.1136/fmch-2021-001085

Heintzman J, Kaufmann J, Bailey S, Lucas J, Suglia SF, Puro J, Giebultowicz S, Ezekiel-Herrera D, Marino M. Asthma Ambulatory Care Quality in Foreign-Born Latino Children in the United States. Acad Pediatr. 2022 May-Jun;22(4):647-656. doi: 10.1016/j.acap.2021.10.003. Epub 2021 Oct 22. PMID: 34688905.

Kaufmann J, Marino M, Lucas J, Bailey SR, Giebultowicz S, Puro J, Ezekiel-Herrera D, Suglia SF, Heintzman J. Racial and Ethnic Disparities in Acute Care Use for Pediatric Asthma. Annals of family medicine. 2022 March;20(2):116-122. PubMed PMID: 35346926; PubMed Central PMCID: PMC8959738; DOI: 10.1370/afm.2771.

Lucas JA, Kaufmann J, Jones M, Garg A, Ezekiel-Herrera D, Puro J, Marino M, Heintzman J. Role of ethnicity/language in documented rates of pediatric asthma prescription refills. The Journal of asthma : official journal of the Association for the Care of Asthma. 2023 February;60(2):360-367. PubMed PMID: 35259312; PubMed Central PMCID: PMC9485292; DOI: 10.1080/02770903.2022.2051545.

Hodes T, Marino M, Lucas JA, Bazemore A, Peterson L, Trivedi MK, Giebultowicz S, Heintzman J. Quality of Care for Latinx Children with Asthma: Associations with Language Concordance and Continuity of Care. Journal of the American Board of Family Medicine : JABFM. 2023 August 9;36(4):616-625. PubMed PMID: 37321656; PubMed Central PMCID: PMC10578095; DOI: 10.3122/jabfm.2022.220379R1.

Lucas JA, Hsu A, Heintzman J, Bailey SR, Suglia SF, Bazemore A, Giebultowicz S, Marino M. The Association of Mobility, Social Deprivation, and Pediatric Primary Care Outcomes in Community Health Centers. The Journal of pediatrics. 2023 August;259:113465. PubMed PMID: 37179014; PubMed Central PMCID: PMC10524636; DOI: 10.1016/j.jpeds.2023.113465.

Lucas JA, Marino M, Bailey SR, Hsu A, Datta R, Cottrell E, Kim YJ, Suglia SF, Bazemore A, Heintzman J. Association of household and neighborhood-level poverty with pediatric asthma care quality varies by race/ethnicity. Submitted to Fam Med Community Health, Accepted July 2023.

Lucas JA, Marino M, Trivedi M, Datta R, Ezekiel-Herrera D, Bailey SR, Giebultowicz S, Heintzman J. Association of early childhood wheeze and asthma diagnosis documentation by race, ethnicity, and language in children receiving care at US community health centers. JABFM, Accepted July 2023.

Kasten-Arias, C., Hodes, T., Marino, M., Kaufmann, J., Lucas, J. A., Estela Vasquez Guzman, C., Giebultowicz, S., Chan, B., & Heintzman, J. (2024). Healthcare utilization for asthma exacerbation among children of migrant and seasonal farmworkers. Preventive medicine reports, 38, 102598. https://doi.org/10.1016/j.pmedr.2024.102598

Latinos and Cancer Equity in Primary Care

The PRIMER Center has published work showing significant engagement with by Latinos with primary cancer screening in community health centers. However, when care requires referral, inequities can appear at times between Latinos and non-Hispanic whites

Heintzman J, Hatch B, Coronado G, Ezekiel D, Cowburn S, Escamilla-Sanchez O, Marino M. Role of Race/Ethnicity, Language, and Insurance in Use of Cervical Cancer Prevention Services Among Low-Income Hispanic Women, 2009–2013. Prev Chronic Dis 2018;15:170267.DOI: https://doi.org/10.5888/pcd15.170267.

Heintzman J, Ezekiel-Herrera D, Quiñones A, Lucas JA, Carrol J, Giebultowicz S, Cottrell E, Marino M. Disparities in Colorectal Cancer Screening in Latinos and Non-Hispanic Whites. American Journal of Preventive Medicine. 2021 Oct 11;S0749-3797(21)00434-7. doi:10.1016/j.amepre.2021.07.009

Chan, B. L., et al. (2023). "Screening for Hepatitis C Among Community Health Center Patients by Ethnicity and Language Preference." AJPM Focus 2(2): 100077.

Heintzman J, Hodes T, Parras D, Lucas JA, Guzman CEV, Chan B, Banegas MP, Marino M. The role of language in mammography orders among low-income Latinas over a 10-year period. Preventive medicine. 2023 August 18;175:107657. PubMed PMID: 37573954; DOI: 10.1016/j.ypmed.2023.107657.

Huguet, N., Holderness, H., Vasquez Guzman, C. E., Marino, M., & Heintzman, J. (2024). Achieving Cancer Equity by Improving Health Insurance Access for All Latinos. Journal of primary care & community health, 15, 21501319241278874. https://doi.org/10.1177/21501319241278874

Latinos and Cardiovascular (and its risk factors) in Primary Care

In this large domain, the PRIMER Center has shown that Latino patients similarly may utilize screening services for cardiovascular disease more than other groups, but may not always have risk factors as well-controlled.

Heintzman, J. Bailey SR, Muench J, Killerby M, Cowburn S, Marino M. A lack of lipid screening disparities in obese Latino adults at health centers. American Journal of Preventive Medicine. 2017;52(6):805-809.

Bailey SR Heintzman J, Jacob RL, Puro J, Marino M. Disparities in Smoking Cessation Assistance in US Primary Care Clinics. Am J Public Health. 2018; 108:1082–1090.

Bailey SR, Marino M, Ezekiel-Herrera D, Schmidt T, Angier H, J Hoopes M, JE DeVoe J, Heintzman J, Nathalie Huguet N. Tobacco Cessation in Affordable Care Act Medicaid Expansion States Versus Non-expansion States, Nicotine & Tobacco Research. https://doi.org/10.1093/ntr/ntz087

Bailey SR, Fankhauser K, Marino M, Schmidt T, Giebultowicz S, Ezekiel-Herrera D, Heintzman J. Smoking Assessment and Current Smoking Status Among Adolescents in Primary Care Settings. Nicotine and Tobacco Research. 2020. https://doi.org/10.1093/ntr/ntaa106

Kaufmann J, Marino M, Lucas JA, Rodriguez CJ, Bailey SR, April‐Sanders AK, Boston D, Heintzman J. Racial, ethnic, and language differences in screening measures for statin therapy following a major guideline change. Preventive medicine. 2022 November;164:107338. PubMed PMID: 36368341; PubMed Central PMCID: PMC9703970; DOI: 10.1016/j.ypmed.2022.107338.

Heintzman J, Kaufmann J, Rodriguez CJ, Lucas JA, Boston D, April-Sanders AK, Chung-Bridges K, Marino M. Statin Eligibility and Prescribing Across Racial, Ethnic, and Language Groups over the 2013 ACC/AHA Guideline Change: a Retrospective Cohort Analysis from 2009 to 2018. Journal of general internal medicine. 2023 March 28. PubMed PMID: 36977971; DOI: 10.1007/s11606-023-08139-x.

Boston, D., Hwang, J., Lucas, J. A., Marino, M., Larson, Z., Sun, E., Giebultowicz, S., Crookes, D. M., Rodriguez, C. J., & Heintzman, J. (2024). Latino-White Disparities in Identification and Control of Elevated Blood Pressure Among Adults With Hypertension. Journal of the American Heart Association, 13(6), e033151. https://doi.org/10.1161/JAHA.123.033151

Kaufmann J, Marino M, Lucas JA, Rodriguez CJ, Boston D, Giebultowicz S, Heintzman J. Atherosclerotic Cardiovascular Disease Primary and Secondary Prevention in Latino Subgroups. Journal of General Internal Medicine, May 2024.

Hodes T., Marino M., Kaufmann J., Lucas JA., Giebultowicz S., Heintzman J. Sex, Ethnicity and Language Differences in Statin Prescribing in Community Health Center Patients with Atherosclerotic Cardiovascular Disease. Accepted September 2024. American Journal of Preventive Cardiology

Latinos and Diabetes in Primary Care

The PRIMER Center has shown that Latino patients similarly may utilize screening and monitoring services for diabetes more than other groups, but may not always have controlled HbA1c levels.

Aceves, B., Ezekiel-Herrera, D., Marino, M., Datta, R., Lucas, J., Giebultowicz, S., & Heintzman, J. (2022). Disparities in HbA1c testing between aging US Latino and non-Latino white primary care patients. Preventive medicine reports, 26, 101739. https://doi.org/10.1016/j.pmedr.2022.101739

Datta, R., Lucas, J. A., Marino, M., Aceves, B., Ezekiel-Herrera, D., Vasquez Guzman, C. E., Giebultowicz, S., Chung-Bridges, K., Kaufmann, J., Bazemore, A., & Heintzman, J. (2022). Diabetes Screening and Monitoring Among Older Mexican-Origin Populations in the U.S. Diabetes care, 45(7), 1568–1573. https://doi.org/10.2337/dc21-2483

Lucas, J. A., Marino, M., Giebultowicz, S., Dinh, D., Datta, R., Boston, D., & Heintzman, J. (2024). Association of neighbourhood walkability and haemoglobin A1c levels among Latino and non-Hispanic White patients with diabetes. Family practice, cmae018. Advance online publication. https://doi.org/10.1093/fampra/cmae018

Ezekiel-Herrera D, Marino M, Lucas JA, Datta R, Aceves B, Boston D, Heintzman J. Association between ethnicity, language and metformin prescriptions in U.S. community health center patients with diabetes. Preventive Medicine, May 2024.

Datta, R., Lucas, J. A., Marino, M., Crookes, D. M., Aceves, B., Ezekiel-Herrera, D., Bazemore, A., & Heintzman, J. D. (Submitted: 03-05-2024; Revised: 05-30-2024; Accepted: 06-03-2024). Diabetes Monitoring in Foreign-Born and US-Born Latino Adults in US Community Health Centers. Journal of the American Board of Family Medicine. https://www.jabfm.org/content/diabetes-monitoring-foreign-born-and-us-born-latino-adults-us-community-health-centers. In production for ahead of print.

Latinos and Infectious Disease/Immunization Equity in Primary Care

The PRIMER Center has written about a clear increased utilization of immunizations by Latinos (especially Spanish-preferring Latinos) in community health centers. This body of work strongly highlights the potential health resources of Latinos, which needs to be better understood by healthcare organizations.

Heintzman J, O’Malley J, Marino M, Todd J, Stange K, Huguet N, Gold R. SARS-CoV-2 testing and changes in primary care services in a multistate network of community health centers during the COVID-19 pandemic. JAMA. 2020;324(14):1459-1462. doi:10.1001/jama.2020.15891

Heintzman J, Bailey S, Cowburn S, Dexter E, Carroll J, Marino M. Pneumococcal vaccination in low-income Latinos: an unexpected finding in Oregon community health centers. Journal of Health Care for the Poor and Underserved. 2016;27(4):1733-1744.

Heintzman J, Hwang J, Quiñones AR, Guzman CEV, Bailey SR, Lucas J, Giebultowicz S, Chan B, Marino M. Influenza and pneumococcal vaccination delivery in older Hispanic populations in the United States. J Am Geriatr Soc. 2022 Mar;70(3):854-861. doi: 10.1111/jgs.17589. Epub 2021 Dec 2. PMID: 34854478.

Lucas JA, Marino M, Datta R, Chan BL, Heintzman JD. Ethnicity, Language, and HIV Screening in Older Adult Safety‐Net Patients. American journal of preventive medicine. 2023 July;65(1):112‐116. PubMed PMID: 36754743; PubMed Central PMCID: PMC10293068; DOI: 10.1016/j.amepre.2023.01.019.

Reports from Latino Primary Care Annual Summits